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目的:研究冠心病患者血糖水平与冠状动脉病变特征的关系。方法:159例经冠状动脉造影确诊的冠心病患者,根据血糖状态分为3组,A组为正常血糖组,B组为空腹血糖受损组,C组为糖尿病组。所有患者均行DSCT冠状动脉成像并对斑块分型。结果:①C组单支血管病变的比例明显低于A组、B组,但多支血管病变的比例明显多于A组、B组(均P<0.01);C组左主干病变、弥漫性病变比例明显多于A、B组(P<0.05、P<0.01)。A组与B组比较差异无统计学意义;②3组患者冠状动脉内共检出397个斑块,C组总斑块数目明显多于A组和B组(均P<0.01),软斑块比例明显高于A组、B组(P<0.05、P<0.01)。A组与B组总斑块数目和软斑块数比例差异无统计学意义;③A、B、C组最大斑块直径狭窄百分数(MPA)分别为(68.98±12.94)%、(69.36±13.07)%、(75.57±11.81)%。C组与A、B组比较差异有统计学意义(均P<0.05),A组与B组比较差异无统计学意义。结论:冠心病伴发糖尿病患者其冠状动脉病变更加严重,易损斑块的发生率更高。
Objective: To study the relationship between blood glucose and coronary artery disease in patients with coronary heart disease. Methods: A total of 159 patients with coronary heart disease confirmed by coronary angiography were divided into 3 groups according to the state of blood glucose. Group A was normal glucose group, group B was impaired fasting glucose group and group C was diabetic group. All patients underwent DSCT coronary angiography and plaque classification. Results: ① The proportion of single vessel lesion in group C was significantly lower than that in group A and group B, but the proportion of multivessel vessel lesion in group C was significantly higher than that in group A and group B (all P <0.01) The proportion was significantly more than A, B group (P <0.05, P <0.01). There was no significant difference between group A and group B; (3) A total of 397 plaques were detected in the coronary arteries in group 3, and the number of total plaques in group C was more than that in group A and B (all P <0.01) The proportion was significantly higher in group A and group B (P <0.05, P <0.01). There was no significant difference in the total number of plaque and the number of soft plaque in group A and group B; ③ The maximum plaque diameter percentage (MPA) in group A, B and C were (68.98 ± 12.94)% and (69.36 ± 13.07) %, (75.57 ± 11.81)%. The difference between group C and group A and group B was statistically significant (both P <0.05). There was no significant difference between group A and group B. Conclusion: Coronary artery disease is more serious in patients with coronary heart disease associated with diabetes, and the incidence of vulnerable plaque is higher.